NOTIFICATION OF CHANGE IN ACCESS TO SERVICES
Providers must immediately notify Value Behavioral Health of PA, Inc. (VBH-PA) by calling their Provider Field Coordinator or through notification in writing by mail, email or facsimile to 1-855-541-5211 (attention Provider Relations Department) upon the occurrence of any of the following:
- Inability to provide emergent care within one hour, urgent care within 24 hours, or routine care within seven days;
- Usage of alternative provider coverage in any situation when unable to treat VBH-PA members in active treatment (e.g. vacation);
- When reaching full (100%) capacity. Full capacity is considered the point at which the provider is unable to meet the access standards noted above or is unable to accept referrals for a particular level of care. Notices for full (100%) capacity should contain the reason for reaching capacity, the effective date, and the steps the provider will take to resume functioning at normal capacity.
- The inability to provide any portion of a prescribed service, e.g. BHRS.
Network providers must offer hours of operation that are no less than the hours of operation offered to commercial members or comparable to Medicaid fee-for-service if the provider serves only Medicaid members.